Comparison of precancerous conditions: atrophy and intestinal metaplasia in Helicobacter pylori gastritis among Chinese and Dutch patients

Aim-Atrophy and intestinal metaplasia (IM) as precancerous conditions consi stently begin in the antrum and are most severe along the lesser curvature. The aim of this study was to investigate discrepancies in the prevalence, the severity of atrophy, and LM in antral mucosa of Helicobacter pylori inf ected gastritis and difference in age of onset among Chinese and Dutch pati ents. Methods-Two hundred and sixty five Chinese patients and 261 Dutch patients with H pylori infection were enrolled. The degrees of atrophy and IM were g raded according to the updated Sydney system. Results-The overall prevalences of atrophy and IM were lower in Dutch patie nts (42% and 26%, respectively) than in Chinese patients (52% and 32%, resp ectively). Only the difference in atrophy reached significance (p = 0.028). However, in both Chinese and Dutch patients, the degrees of atrophy and IM were low and severe degrees were rare. The mean ages of Chinese and Dutch patients with atrophy and IM were higher than those without atrophy and IM (with atrophy (Chinese patients): mean, 42.12; SD, 9.80; with IM (Chinese p atients): mean, 42.56; SD, 9.96; with atrophy (Dutch patients): mean, 55.16 ; SD, 12.20; with LM (Dutch patients): mean, 57.79; SD, 11.13; without atro phy (Chinese patients): mean, 39.71; SD, 10.16; without IM (Chinese patient s): mean, 40.19; SD, 9.99; without atrophy (Dutch patients): mean, 45.70; S D, 12.44; without IM (Dutch patients): mean, 46.89; SD, 12.68). Atrophy and IM occurred earlier and were more severe in Chinese patients, with both re aching a peak value in patients over 60 years. Conclusions-There are geographical differences in the prevalence and severi ty of H pylori infected gastritis, in particular with respect to atrophy an d LM, which suggests that infection with H pylori occurs earlier in life an d has a higher prevalence in China.